Penumbra

Beth had always known it would be a matter of time. Ricky had treated his body like a garbage dump for Beth’s entire life. He drank more than he didn’t, and he was never without a pack of cigarettes, crushed under the weight of his rapidly expanding gut. When she was 12, her health teacher had given them a talk on the risks of smoking. Beth’s eyes had grown wide as saucers when she learned that smoking could kill you, and she raced home to tell her Dad.

“Oh honey,” he laughed, “I don’t plan on being here for long”. She looked frantically to her mother, trying to figure out if he meant what she thought he meant and saw that she was laughing too. Her face grew hot, both from anger at her father for never saying the right thing and from shame for never understanding the joke.

She had printed off a bunch of anti-smoking posters to get her revenge, each fluorescent-colored sheet outlining the many ways smoking could kill you. She plastered these all over their house and went to bed feeling smug. The next morning, she smiled as she heard her father ripping them down and saying to her mother that “Beth should mind her own business”, because she knew, from the loud, brassy tone of his voice, that the posters had bothered him. She kept up her nightly crusade until one day the ink cartridge was missing. That empty space in the printer was enough to make Beth realize he would never quit.

And now here she was, in the Family Lounge at the hospital, waiting to speak to her father’s neurologist. Ricky had collapsed at work and was at the hospital. Or so she had been told–this was the most she had heard of her father’s life since she moved out of the house. She had never set out to explicitly stop talking to him, but then again, she had never been determined to keep a relationship either. She found his thinly-veiled disapproval of her career as a lawyer both hilarious and infuriating; when she called him to tell him she had gotten into law school, he had been quiet, then laughed.

“Wow, working for the man, huh Lizzy? I always thought you were more rock and roll than that.”

“I think making money and sending criminals to jail is pretty rock and roll, thanks.”

She knew she shouldn’t engage with him and that it would only end in a fight, but she had really thought he would at least be somewhat proud.

“What do you do again, Ricky?”

She regretted it the moment she said it, for Ricky’s recent stint on disability had been hard on him. But he had pushed her, as he always did until she became the monstrous bitch he claimed she was. They didn’t speak again for 6 months after that conversation. And this was how it came to be that she was almost 30 and hadn’t seen her father in three years, despite living in the same city as him. Every phone call would turn into an argument, she would cry, and then the interval between these calls became longer and longer until she realized she had missed his 60th birthday. It made her a little sad, but she wasn’t finished being angry with him.
The problem was that she wasn’t always sure what she was angry with him for. For not being the father she had wanted growing up — the kind who would teach her how to drive and try not to drink in front of her. The one who would get to know the guys she dated over a dinner table instead of inviting them out to his shed to get high. But she was also angry at him for something more, something else, that she couldn’t quite figure out. She spent many nights downplaying these emotions with friends, always saying the same hollow line: “Family isn’t always forever.”

Because of this, no one had been more surprised than her to get a call from the hospital early this morning. Because of the message, yes, but also because it meant Ricky had her phone number. Her first feeling was one of relief because it meant their lack of communication was as much his fault as it was hers. This was followed by gut-wrenching guilt when she realized he was gravely ill. It was the guilt that had propelled her downtown to the hospital before she had the chance to think about the politics of going. These thoughts came to her in the waiting room: how her mother would feel if she knew she was seeing Ricky (betrayed, then guilty), what her boyfriend would say (“So do you want to … talk about it?”), and, the big one, how Ricky would react when he saw her (awkward silence was her best guess).

She had almost talked herself into leaving when the neurologist walked in. She didn’t need the stress, she barely knew her father anymore, and, besides, she was in court tomorrow. She could see the pros and cons list written down; one column far exceeded the other. But she just couldn’t leave. Perhaps it was the lawyer in her, but she knew that degree of betrayal would commit her to a lifetime of being a bad daughter. The evidence would be too black and white. She was too busy figuring out a way to leave without being the worst person in the world (if only her court case had been today) that she didn’t notice the neurologist sit down in front of her.

“Ms. Klein. My name is Dr. Williams. You are Richard’s daughter, yes?” He was wearing a crisp blue button down — the kind where even the buttons look expensive — but his watch was a flimsy, plastic Timex. She pegged him at mid-forties.

“Yes. I admit I haven’t spoken to him in some time. I just received a call this morning, and thought I should probably come… ” She felt herself trail off, not sure how much information she was supposed to give. She hated oversharing.

“Oh, I see. Okay, hmm, alright.” He looked inexplicably concerned by this answer, and she felt the rage building up inside of her. She was used to this reaction from strangers, friends even. Everyone seemed to cling to the idea that fathers always loved their daughters, and vice versa. But she had hoped those in the medical field saw the truth, the way she did in her court cases; everyone can fucking hate each other if they really try.

“Is that a problem? I’m here, aren’t I?” She knew she shouldn’t snap at him, but his long pause was too much for her.

“Oh, no, I’m sorry Ms. Klein, it’s not that. It’s just, ahh … well, let me start from the beginning. I’m not sure how much you know, but I have some bad news.” He paused to take a breath and looked at her expectantly.

“Okay, I figured as much. What happened?”

“Your father Richard has had a stroke. We were able to treat him quickly, which is important, but there has been significant damage to his brain.” Again, the look.

“Okay … that’s unfortunate… ” Couldn’t they have told her this on the phone?

“Well, see Ms. Klein, your father lived alone. He is a good candidate for stroke rehab — he still has most of his speech and comprehension, and he seems to have a desire to get better. So we hope he will go there once he is discharged from the acute stroke unit. But I’m sorry to say that there is likely no way your father will ever be able to live independently again, even after rehab.”
Beth inhaled sharply. This was why she was here.

“I see … I don’t think that I could, exactly, like, I don’t know, take care of him? Is that what you’re asking me to do?” This was too much. Too fast. She wasn’t even going to come to the hospital.

“Well, that is something you and your family have to think about. It is your choice. Your father was just asking for you quite a bit. I made an assumption that you were close, my apologies.”

God, just stick the knife in. Of course, he was asking for her. He had always just expected her to be there, no matter what. The apologetic, expectant face of Dr. Williams beamed back at her, and she felt crushed under all of these expectations.

“No, no, it’s okay … we were close, once.” Not exactly a lie.

“These things happen, yes. Families are complicated. But you were the first next of kin we could reach, and we need you to sign some forms on behalf of your father if you feel up for it.”

“Hmm … I guess, yeah, I could. I really don’t know what he would want, I don’t know.” Beth squirmed in her chair.

“Well, maybe we could just go over them together. Perhaps you would like to see Richard. He is awake now.” He was speaking slowly, choosing his words carefully.

“Yeah, okay, umm, what condition is he in, exactly? Will he know who I am?” She was stalling, putting more words between her and her father.

“I think so. He has lost mostly motor function, the ability to move his arms and facial muscles. But it has only been two days — your father could still improve.” He looked hopefully at her.

“Really? I thought a stroke meant that your brain cells are dead — gone.” Man, she was really stalling now. Maybe he would explain how strokes work in immense detail and then her father would be asleep and she could sign those forms and leave. Or maybe she should see him and get it over with. Or maybe she should book it out of here, immediately.

He took the bait. “Well, actually, in the type of stroke your father had, there’s a small section of the brain that dies, but there’s always a bigger section that could get better, with the right treatment. This section is called the penumbra. I do a lot of research in this area, actually.”

He flushed, and for a second she could see the nerdy medical student he once was, poring over textbooks and studying the brain just so he could have these kinds of moments. It made her feel profoundly sad like a light had gone out in her and she hadn’t even realized it. When did she get so cynical?

“Ohh, okay. So the rehab, it could help this area get better?”

“Yes, exactly! That is our hope. And he has received excellent care thus far. The period right after a stroke is incredibly important, and I think we treated your father quite quickly.” He beamed at her, and she got a weird sense that he was proud of her for asking.

“I don’t want to rush you, Ms. Klein. If you want to think about what I’ve told you before seeing your father, that is fine. I will be here all afternoon, you can ask the nurse to page me.” He stood up and handed her his card.

She watched him get up to leave and had the strongest urge to follow him.

“Wait, no, I’ll … I’ll come now. I’ll see him. Will you take me to his room?” Her mouth was dry and her hands felt tingly like they did right before she made her closing arguments in court.

“Sure, it’s on my way. I’ll have the nurse bring the forms over to you.” He smiled and opened the door for her.

She was dismayed to find out that her father’s room was only a few steps down the hallway. No more stalling.

“Here you are, Ms. Klein.” He stood outside the door and smiled.

“You’re not coming in?” She had thought he would introduce her, be her guide through these uncharted waters.

He smiled a tight, strained smile. “Not this time, I’m afraid. I have a few more patients to see. Good luck, Ms. Klein.” He shook her hand, then left her standing in front of her father’s door alone.

She looked at the crack in the tile right under the doorframe. There was no going back now.

Maggie Hulbert is a third year medical student at Queen's University School of Medicine in Kingston, Canada. In 2015, she graduated from Queen's University with a Bachelor of Science in life sciences. She is an active member of the medical humanities community and spent this past year developing the first Jacalyn Duffin Health and Humanities Conference. Her favorite writers include Danielle Ofri, Roxane Gay, and Samantha Irby. After graduating medical school, Maggie would like to pursue a career in Psychiatry.

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